TY - JOUR
T1 - Management of tracheostomy in COVID-19 patients
T2 - The Japanese experience
AU - Yokokawa, Taizo
AU - Ariizumi, Yosuke
AU - Hiramatsu, Mariko
AU - Kato, Yujin
AU - Endo, Kazuhira
AU - Obata, Kazufumi
AU - Kawashima, Kayoko
AU - Sakata, Toshifumi
AU - Hirano, Shigeru
AU - Nakashima, Torahiko
AU - Sekine, Tatsurou
AU - Kiyuna, Asanori
AU - Uemura, Saeko
AU - Okubo, Keisuke
AU - Sugimoto, Taro
AU - Tateya, Ichiro
AU - Fujimoto, Yasushi
AU - Horii, Arata
AU - Kimura, Yurika
AU - Hyodo, Masamitsu
AU - Homma, Akihiro
N1 - Publisher Copyright:
© 2021
PY - 2021/6
Y1 - 2021/6
N2 - Objective: Involvement in the tracheostomy procedure for COVID-19 patients can lead to a feeling of fear in medical staff. To address concerns over infection, we gathered and analyzed experiences with tracheostomy in the COVID-19 patient population from all over Japan. Methods: The data for health-care workers involved in tracheostomies for COVID-19-infected patients were gathered from academic medical centers or their affiliated hospitals from all over Japan. Results: Tracheostomies have been performed in 35 COVID-19 patients with a total of 91 surgeons, 49 anesthesiologists, and 49 surgical staff members involved. Twenty-eight (80%) patients underwent surgery more than 22 days after the development of COVID-19-related symptoms (11: 22–28 days and 17: ≥29 days). Thirty (85.7%) patients underwent surgery ≥ 15 days after intubation (14: 15–21 days, 6: 22–28 days, and 10: ≥29 days). Among the total of 189 health-care workers involved in the tracheostomy procedures, 25 used a powered air-purifying respirator (PAPR) and 164 used a N95 mask and eye protection. As a result, no transmission to staff occurred during the 2 weeks of follow-up after surgery. Conclusion: No one involved in tracheostomy procedures were found to have been infected with COVID-19 in this Japanese study. The reason is thought to be that the timing of the surgery was quite late after the infections, and the surgery was performed using appropriate PPE and surgical procedure. The indications for and timing of tracheostomy for severe COVID-19 patients should be decided through multidisciplinary discussion.
AB - Objective: Involvement in the tracheostomy procedure for COVID-19 patients can lead to a feeling of fear in medical staff. To address concerns over infection, we gathered and analyzed experiences with tracheostomy in the COVID-19 patient population from all over Japan. Methods: The data for health-care workers involved in tracheostomies for COVID-19-infected patients were gathered from academic medical centers or their affiliated hospitals from all over Japan. Results: Tracheostomies have been performed in 35 COVID-19 patients with a total of 91 surgeons, 49 anesthesiologists, and 49 surgical staff members involved. Twenty-eight (80%) patients underwent surgery more than 22 days after the development of COVID-19-related symptoms (11: 22–28 days and 17: ≥29 days). Thirty (85.7%) patients underwent surgery ≥ 15 days after intubation (14: 15–21 days, 6: 22–28 days, and 10: ≥29 days). Among the total of 189 health-care workers involved in the tracheostomy procedures, 25 used a powered air-purifying respirator (PAPR) and 164 used a N95 mask and eye protection. As a result, no transmission to staff occurred during the 2 weeks of follow-up after surgery. Conclusion: No one involved in tracheostomy procedures were found to have been infected with COVID-19 in this Japanese study. The reason is thought to be that the timing of the surgery was quite late after the infections, and the surgery was performed using appropriate PPE and surgical procedure. The indications for and timing of tracheostomy for severe COVID-19 patients should be decided through multidisciplinary discussion.
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U2 - 10.1016/j.anl.2021.01.006
DO - 10.1016/j.anl.2021.01.006
M3 - Article
C2 - 33446370
AN - SCOPUS:85099133260
VL - 48
SP - 525
EP - 529
JO - Auris Nasus Larynx
JF - Auris Nasus Larynx
SN - 0385-8146
IS - 3
ER -